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Pessary use for reduction of preterm birth (March 2016)

Pessary use for reduction of preterm birth (March 2016)

The efficacy of using a vaginal pessary to
improve pregnancy outcome in women with a short cervix is
controversial. Recently, the largest randomized trial of
pessary use in pregnant women with a short cervix (n = 932
participants) reported no differences between the pessary
and control (no pessary) groups in rates of spontaneous
delivery <34 weeks, perinatal death, adverse neonatal
events, or need for neonatal special care [6]. We believe
the body of evidence does not support pessary use for
pregnant women with a short cervix. However, further study
is warranted as the available evidence is limited by
differences in use of progesterone prophylaxis and the low
number of preterm births and neonatal complications in
published trials. (See"Cervical
insufficiency", section on 'Pessary'.)